NUR 2214 NURSING CARE OF THE OLDER ADULT QUIZ 4
2026/2027 | Questions and Answers | Already Graded A |
Rasmussen College | Pass Guaranteed
Domain 1: Physiological Changes of Aging (10 Questions)
Q1: A 78-year-old patient reports feeling dizzy when standing up from bed in the
morning. Vital signs show BP 142/88 mmHg supine, changing to 98/62 mmHg after
standing for 1 minute, with heart rate increasing from 72 to 96 bpm. Which age-related
physiological change best explains this finding?
A. Decreased baroreceptor sensitivity and reduced venous return due to vascular
stiffness
B. Pathological autonomic failure indicating Parkinson's disease
C. Dehydration from inadequate fluid intake common in older adults
D. Side effects of antihypertensive medications only
Correct Answer: A [CORRECT]
Rationale: This presentation demonstrates orthostatic (postural) hypotension, a
common age-related physiological change. Baroreceptor sensitivity decreases with
aging, reducing the reflex tachycardia and vasoconstriction needed to maintain blood
pressure with position changes. Additionally, reduced venous compliance and increased
vascular stiffness impair the capacitance function of veins, reducing preload to the
heart. These are normal age-related cardiovascular changes, not necessarily pathology.
, ● Option B is incorrect because while autonomic failure occurs in Parkinson's
disease, isolated orthostatic hypotension in an older adult is most commonly due
to normal aging changes, not neurodegenerative disease. No other Parkinson's
symptoms (tremor, bradykinesia, rigidity) are mentioned.
● Option C is incorrect while dehydration can cause orthostatic changes, the
specific pattern described (supine hypertension with standing hypotension) is
characteristic of age-related baroreceptor dysfunction and vascular changes, not
solely volume depletion.
● Option D is incorrect because while medications can contribute, the question
asks for the age-related physiological change. Even without medications, these
hemodynamic changes occur with normal aging due to structural and functional
cardiovascular changes.
Q2: A nurse is assessing lung function in an 82-year-old patient. Which finding
represents a normal age-related respiratory change rather than pathology?
A. Decreased forced expiratory volume in 1 second (FEV1) and increased residual
volume
B. Productive cough with yellow sputum and fever
C. Oxygen saturation of 88% on room air at rest
D. Pleuritic chest pain with diminished breath sounds
Correct Answer: A [CORRECT]
Rationale: Normal age-related respiratory changes include decreased elastic recoil of
lung tissue, calcification of costal cartilage (reduced chest wall compliance), and
weakening of respiratory muscles. This results in decreased FEV1, FVC, and increased
residual volume (air trapping) with a normal FEV1/FVC ratio. These changes represent
presbylung—normal aging—not disease.
● Option B is incorrect because productive cough with purulent sputum and fever
indicates infection (pneumonia, bronchitis), not normal aging. While older adults
have increased infection risk, these symptoms are always pathological.
, ● Option C is incorrect because SpO2 88% is never normal at any age. Normal
oxygen saturation is ≥95% (some accept ≥92% in very old adults at altitude).
Values below 90% indicate hypoxemia requiring intervention.
● Option D is incorrect because pleuritic pain and diminished breath sounds
suggest pathology (pneumothorax, pleural effusion, consolidation), not normal
aging. These findings require immediate diagnostic workup.
Q3: An 85-year-old patient has a serum creatinine of 1.2 mg/dL, which is within the
"normal" laboratory range. However, the nurse calculates the estimated glomerular
filtration rate (eGFR) and finds it is 45 mL/min/1.73m². Which statement best explains
this discrepancy?
A. The laboratory reference range for creatinine is not adjusted for age-related muscle
mass loss
B. The patient has acute kidney injury despite normal creatinine
C. Creatinine is not a reliable marker in older adults and should never be used
D. The eGFR calculation is inaccurate in patients over 80 years
Correct Answer: A [CORRECT]
Rationale: This illustrates a critical concept in geriatric renal assessment: serum
creatinine is an unreliable marker of kidney function in older adults due to sarcopenia
(age-related muscle mass loss). Creatinine is a muscle breakdown product; with
reduced muscle mass, less creatinine is produced, so "normal" serum levels mask
significant renal function decline. The eGFR of 45 mL/min/1.73m² indicates Stage 3A
chronic kidney disease despite "normal" creatinine. Dosing adjustments for
renal-eliminated drugs must use eGFR, not creatinine alone.
● Option B is incorrect because acute kidney injury would show rising creatinine
from baseline or oliguria, not a stable creatinine with reduced eGFR. This
represents chronic age-related nephron loss, not acute injury.
, ● Option C is incorrect because while creatinine has limitations, it remains useful
when interpreted with eGFR formulas that account for age, sex, and race (though
race-based corrections are being eliminated). It is not "never" to be used, but
must be interpreted cautiously.
● Option D is incorrect because eGFR calculations (CKD-EPI, MDRD) are validated
in older adults, though they may underestimate true GFR in very frail elders. The
discrepancy reflects the creatinine-muscle mass relationship, not formula
inaccuracy.
Q4: A nurse is teaching an 80-year-old patient about age-related gastrointestinal
changes. Which statement by the patient indicates understanding of normal aging
effects?
A. "I should expect to have daily bowel movements like when I was younger."
B. "Decreased stomach acid production means I may need B12 supplementation."
C. "My liver will process medications faster as I get older."
D. "I will digest fats more efficiently due to increased bile production."
Correct Answer: B [CORRECT]
Rationale: Atrophic gastritis with decreased intrinsic factor and acid production is a
common age-related GI change, affecting 10-30% of older adults. This leads to vitamin
B12 malabsorption (even without pernicious anemia) and requires supplementation or
increased dietary intake. This is a normal age-related physiological change with clinical
significance.
● Option A is incorrect because decreased bowel movement frequency is common
with aging due to reduced GI motility, decreased fluid intake, and medications.
Expecting daily movements may lead to inappropriate laxative use. Normal
ranges from 3 times/day to 3 times/week.
● Option C is incorrect because hepatic metabolism generally decreases with
aging due to reduced hepatic mass, blood flow, and enzyme activity (particularly
Phase I reactions). This causes prolonged drug half-lives, not faster processing.
2026/2027 | Questions and Answers | Already Graded A |
Rasmussen College | Pass Guaranteed
Domain 1: Physiological Changes of Aging (10 Questions)
Q1: A 78-year-old patient reports feeling dizzy when standing up from bed in the
morning. Vital signs show BP 142/88 mmHg supine, changing to 98/62 mmHg after
standing for 1 minute, with heart rate increasing from 72 to 96 bpm. Which age-related
physiological change best explains this finding?
A. Decreased baroreceptor sensitivity and reduced venous return due to vascular
stiffness
B. Pathological autonomic failure indicating Parkinson's disease
C. Dehydration from inadequate fluid intake common in older adults
D. Side effects of antihypertensive medications only
Correct Answer: A [CORRECT]
Rationale: This presentation demonstrates orthostatic (postural) hypotension, a
common age-related physiological change. Baroreceptor sensitivity decreases with
aging, reducing the reflex tachycardia and vasoconstriction needed to maintain blood
pressure with position changes. Additionally, reduced venous compliance and increased
vascular stiffness impair the capacitance function of veins, reducing preload to the
heart. These are normal age-related cardiovascular changes, not necessarily pathology.
, ● Option B is incorrect because while autonomic failure occurs in Parkinson's
disease, isolated orthostatic hypotension in an older adult is most commonly due
to normal aging changes, not neurodegenerative disease. No other Parkinson's
symptoms (tremor, bradykinesia, rigidity) are mentioned.
● Option C is incorrect while dehydration can cause orthostatic changes, the
specific pattern described (supine hypertension with standing hypotension) is
characteristic of age-related baroreceptor dysfunction and vascular changes, not
solely volume depletion.
● Option D is incorrect because while medications can contribute, the question
asks for the age-related physiological change. Even without medications, these
hemodynamic changes occur with normal aging due to structural and functional
cardiovascular changes.
Q2: A nurse is assessing lung function in an 82-year-old patient. Which finding
represents a normal age-related respiratory change rather than pathology?
A. Decreased forced expiratory volume in 1 second (FEV1) and increased residual
volume
B. Productive cough with yellow sputum and fever
C. Oxygen saturation of 88% on room air at rest
D. Pleuritic chest pain with diminished breath sounds
Correct Answer: A [CORRECT]
Rationale: Normal age-related respiratory changes include decreased elastic recoil of
lung tissue, calcification of costal cartilage (reduced chest wall compliance), and
weakening of respiratory muscles. This results in decreased FEV1, FVC, and increased
residual volume (air trapping) with a normal FEV1/FVC ratio. These changes represent
presbylung—normal aging—not disease.
● Option B is incorrect because productive cough with purulent sputum and fever
indicates infection (pneumonia, bronchitis), not normal aging. While older adults
have increased infection risk, these symptoms are always pathological.
, ● Option C is incorrect because SpO2 88% is never normal at any age. Normal
oxygen saturation is ≥95% (some accept ≥92% in very old adults at altitude).
Values below 90% indicate hypoxemia requiring intervention.
● Option D is incorrect because pleuritic pain and diminished breath sounds
suggest pathology (pneumothorax, pleural effusion, consolidation), not normal
aging. These findings require immediate diagnostic workup.
Q3: An 85-year-old patient has a serum creatinine of 1.2 mg/dL, which is within the
"normal" laboratory range. However, the nurse calculates the estimated glomerular
filtration rate (eGFR) and finds it is 45 mL/min/1.73m². Which statement best explains
this discrepancy?
A. The laboratory reference range for creatinine is not adjusted for age-related muscle
mass loss
B. The patient has acute kidney injury despite normal creatinine
C. Creatinine is not a reliable marker in older adults and should never be used
D. The eGFR calculation is inaccurate in patients over 80 years
Correct Answer: A [CORRECT]
Rationale: This illustrates a critical concept in geriatric renal assessment: serum
creatinine is an unreliable marker of kidney function in older adults due to sarcopenia
(age-related muscle mass loss). Creatinine is a muscle breakdown product; with
reduced muscle mass, less creatinine is produced, so "normal" serum levels mask
significant renal function decline. The eGFR of 45 mL/min/1.73m² indicates Stage 3A
chronic kidney disease despite "normal" creatinine. Dosing adjustments for
renal-eliminated drugs must use eGFR, not creatinine alone.
● Option B is incorrect because acute kidney injury would show rising creatinine
from baseline or oliguria, not a stable creatinine with reduced eGFR. This
represents chronic age-related nephron loss, not acute injury.
, ● Option C is incorrect because while creatinine has limitations, it remains useful
when interpreted with eGFR formulas that account for age, sex, and race (though
race-based corrections are being eliminated). It is not "never" to be used, but
must be interpreted cautiously.
● Option D is incorrect because eGFR calculations (CKD-EPI, MDRD) are validated
in older adults, though they may underestimate true GFR in very frail elders. The
discrepancy reflects the creatinine-muscle mass relationship, not formula
inaccuracy.
Q4: A nurse is teaching an 80-year-old patient about age-related gastrointestinal
changes. Which statement by the patient indicates understanding of normal aging
effects?
A. "I should expect to have daily bowel movements like when I was younger."
B. "Decreased stomach acid production means I may need B12 supplementation."
C. "My liver will process medications faster as I get older."
D. "I will digest fats more efficiently due to increased bile production."
Correct Answer: B [CORRECT]
Rationale: Atrophic gastritis with decreased intrinsic factor and acid production is a
common age-related GI change, affecting 10-30% of older adults. This leads to vitamin
B12 malabsorption (even without pernicious anemia) and requires supplementation or
increased dietary intake. This is a normal age-related physiological change with clinical
significance.
● Option A is incorrect because decreased bowel movement frequency is common
with aging due to reduced GI motility, decreased fluid intake, and medications.
Expecting daily movements may lead to inappropriate laxative use. Normal
ranges from 3 times/day to 3 times/week.
● Option C is incorrect because hepatic metabolism generally decreases with
aging due to reduced hepatic mass, blood flow, and enzyme activity (particularly
Phase I reactions). This causes prolonged drug half-lives, not faster processing.
